The pectoralis (pec) muscles are large, highly visible muscles located on each side of the chest. Their primary job is to help the shoulders and arms move and lift. When you perform a push-up or chest fly, you are activating the pecs. Because they are among the strongest muscles in the body, they are less likely to be strained (pulled), but it can happen.

Grade 1 strains involve a few torn muscle or tendon fibers. Loss of strength is minimal, and recovery quite manageable.

Grade 2 strains involve more torn fibers, some loss of strength, and a longer rehab period.

Grade 3 pectoralis strains are rare, painful, debilitating, and can have long-term effects on strength, power, range of motion, and sports performance. In most cases, the muscle will never regain it original strength.

How It Happens

A strained pec can occur in two ways: a traumatic event or long-term overuse. An athlete can be injured when taking a hard blow to the upper body that the pecs cannot withstand.

A chronic strain is less dramatic—overusing the pecs to the point where they begin to tear, either in the muscle tissue or in the tendons that connect the pecs to the ribs and breast bone (sternum). The The Journal of the Academy of Orthopaedic Surgeons is more specific: “Pectoralis major muscle tears are relatively rare injuries that occur while lifting weights, particularly when doing a bench press.”

Who’s At Risk

Weightlifters are in the highest risk group, but the injury has been reported in rugby players, wrestlers, rodeo athletes, boxers, skiers, sailboarders, football players, hockey players and pole vaulters.

Symptoms

Severe pain in the chest area

Swelling, bruising (may extend into the shoulder and upper arm in severe cases)

Loss of strength, particularly when lifting

Difficulty in moving the arm across the chest

Initial Treatment

Apply ice packs for 15-20 minutes, 3-4 times a day for the first 48-72 hours

Avoid or limit any activity that causes chest wall pain

Get immediate medical attention if the strain is severe. Surgery is usually required for a complete pec rupture

Comeback Strategy

As in recovering from any other muscle strain, think about returning to training and competition when pain has subsided, strength has been regained, and range of motion is back to normal, regardless of how much time has elapsed.

Grade 1 recovery takes a matter of days. You can return to training when the symptoms have disappeared.